Millions more Americans will need to lower blood pressure

Photo Credit To Whitten Sabbatini/The New York Times

The nation’s leading heart experts on Monday issued new guidelines for high blood pressure that mean tens of millions more Americans will meet the criteria for the condition, and will need to change their lifestyles or take medicines to treat it.

Under the guidelines, formulated by the American Heart Association and the American College of Cardiology, the number of men younger than 45 with a diagnosis of high blood pressure will triple, and the prevalence among women younger than 45 will double.

“Those numbers are scary,” said Dr. Robert M. Carey, professor of medicine at the University of Virginia and co-chair of the committee that wrote the new guidelines.

The number of adults with high blood pressure, or hypertension, will rise to 103 million from 72 million under the previous standard. But the number of people who are candidates for drug treatment will rise only by an estimated 4.2 million people, he said. The rest should be able to meet the goals with lifestyle changes.

High blood pressure is second only to smoking as a preventable cause of heart attacks and strokes, and heart disease remains the leading killer of Americans.

If Americans act on the guidelines and lower their blood pressure by exercising more and eating a healthier diet, or with drug therapy, they could drive an already falling death rate from heart attacks and stroke even lower, experts said.

Now, high blood pressure, or hypertension, will be defined as 130/80 millimeters of mercury or greater for anyone with a significant risk of heart attack or stroke. The previous guidelines defined high blood pressure as 140/90.

Cardiovascular disease remains the leading cause of death among Americans. The new criteria, the first official diagnostic revision since 2003, result from growing evidence that blood pressure far lower than had been considered normal greatly reduces the chances of heart attack and stroke, as well as the overall risk of death.

Recent research indicates this is true even among older people for whom intensive treatment had been thought too risky.

That calculation must be individualized, and experts are recommending that patients use a calculator developed by the guidelines committee at ccccalculator.ccctracker.com.